Doctors warn against attention-boosting drugs for undiagnosed kids

Connor Forrest, Medill News Service

The American Academy of Neurology took a formal stance
Wednesday on the useof attention-altering drugs by
children who do not have a formal diagnosis.In a
position paper, the academy outlined the ethical issues for
treatinghealthy children with such drugs, a concept
known as neuroenhancement.

"Neuroenhancement is using a medication of any kind -- a
drug, a medication,to, in some way, improve, or at
least have the perception of improvingcognitive
function, thinking, memory, performance in some way, in
someonewho does not have a diagnosable condition,"
said Dr. Leon Epstein, whoworked on the
paper.

The position comes on the heels of a similar paper done for
adult patientsreleased in 2009. According to Epstein,
the issue is that children cannotmake the same
decisions as adults, and doctors are supposed to makedecisions that are in the best interest of a child's
health.

If a condition is diagnosed, the use of the medicine is a
treatment for thatcondition. Neuroenhancement is
common among college students who takestimulants such
as Adderall to help them study for exams. The drugs couldhave been obtained secondhand from someone who was originally
prescribed themedication.

Dr. William Graf, of Yale University, who also worked on the
paper, saidthat the ADHD diagnoses have increased
12-fold over a 20-year period andsome of those could
be attributed to over-diagnosis or over-treatment.

"I think that we have a problem with a large pharmaceutical
industry in thiscountry that is growing, with the
number of tablets and pills that peopletake is
growing," Graf said. "We have to stop at some point and assess
howthis should be practiced, especially with children
and adolescents."

Much of the skepticism occurs at the intersection of
consumerism andmedicine. Pharmaceutical companies are
allowed to advertise their productsto the public and
critics say this is influencing what the public perceivesas proper medical treatment.

"The neuroenhancement issue is really the ethical issue
about whether or notit would be all right for a
physician to prescribe a medication," saidEpstein,
head of the neurology division at Lurie Children's Hospital
inChicago. "In this case we're talking about
stimulants, but it could apply toother medications,
to prescribe a medication to somebody, who is anadolescent or a child, who does not have a diagnosable
condition.

"The position of this paper, of this committee, ultimately
was that no, thatis not ethically
permissible."